• Anaesthesia · Jan 2004

    Review

    Peri-operative beta-blockade and haemodynamic optimisation in patients with coronary artery disease and decreasing exercise capacity presenting for major noncardiac surgery.

    • B M Biccard.
    • Consultant Anaesthetist, Department of Anaesthetics, Nelson R Mandela School of Medicine, Private Bag 7, Congella, 4013, South Africa. brucepen@samedical.co.za
    • Anaesthesia. 2004 Jan 1;59(1):60-8.

    AbstractPatients with coronary artery disease presenting for major noncardiac surgery may have indications for both peri-operative beta-blockade and haemodynamic optimisation. The combination of peri-operative cardiorespiratory failure and myocardial ischaemia has a grave prognosis. Recent investigations have shown that in patients with coronary artery disease, beta-blockade does not depress cardiac output as much as originally thought. There may, therefore, be a place for both peri-operative beta-blockade and haemodynamic optimisation. The indications for peri-operative beta-blockade and haemodynamic optimisation, the effect of acute beta-blockade on cardiac output in patients with coronary artery disease, and the interaction of peri-operative beta-blockade and haemodynamic optimisation are discussed.

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